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Update on NUH services review – Feb 2017

Commissioners make decisions on services after engagement campaign ends

  • Brain injury and neuro services to remain at NUH
  • Agreement to move pain management and back pain into the community to create fully integrated care for patients

Following patient and clinician engagement, commissioners have listened to feedback and can now announce the decisions of the Nottingham University Hospitals (NUH) service review.

Thirty services were reviewed at NUH. For the majority of these, the recommendation was to remain at NUH, some with an updated specification.

However, commissioners also identified seven services that they proposed could be delivered in a community setting, closer to patients’ homes, providing better value to the local NHS and improved outcomes for patients (services listed in the notes below).

Following initial patient engagement, specifications were drawn up, plans were published on Clinical Commissioning Group (CCG) websites and patients, clinicians and local communities were invited to have their say over a six week period (19 December – 5 February 2017).

After going through the patient and clinician feedback process, service changes have been reviewed and final proposals were agreed in Collaborative Commissioning Congress and considered at each of the three CCG’s Governing Bodies. The recommendations were approved on Friday 10 February 2017.

The decisions

Services which will remain with NUH

  • Brain Injury and Neuro-Assessment
  • Conservative Management of Renal Patients (this will be integrated with the dialysis home visiting service)

 Services which will be delivered in the community through either open procurement or integration with existing community services (from July 2017)

  • Pain Management and Back Pain Service – patients will still receive injections in line with NICE guidelines – which might take place in NUH or in the community dependent on clinical requirements
  • Integrated Dietetics Service – across community and acute care (where required care will still take place in the hospital setting).
  • Chronic Fatigue Syndrome Service
  • Home visiting service for patients with Motor-Neurone Disease (patients will still be under consultant care)
  • Geriatric Day Care/ Medicine Day Care/ Complex Rehab – following patient feedback, this service specification will include a separate annex for Parkinson’s disease patients. Engagement is also ongoing with this cohort of patients.

NUH engagement summary per service

Dr James Hopkinson, Clinical Lead, Nottingham North and East CCG says:

“Patient, public and clinician feedback was always going to be integral to our commissioning decisions and we’re pleased we received such a huge response from patient and professionals via patient groups, our website and patient experience team.

“As a CCG, listening to our communities and our patients is critical. We have been happy to do that, and have made adjustments to our plans based on feedback, along with the feedback from a wide range of clinicians.

“We are now confident that the decisions we have taken represent the best way forward for the delivery of these services, whether that be in the community, in a hospital, or in a combination of the two.

“This process illustrates how important the patient voice is, and how we must all work together to plan for the future of healthcare provision in Nottinghamshire.

More information will be available in the next couple of weeks including updated specification summaries. Thank you to all the patients who participated. We’re happy to have listened to what you have told us and have taken into consideration the issues you have raised.

Media enquiries to: 07792 181528


  • During 2016, the Greater Nottingham Clinical Commissioning Groups (Nottingham City, Nottingham North and East, Nottingham West and Rushcliffe) undertook clinically-led reviews on a set of services delivered by Nottingham University Hospitals (NUH) NHS Trust.
  • The driver for these reviews has been to improve quality and to look at where we can provide care closer to home. It was also to ensure that we are getting the very best value for money when commissioning publicly funded health services.
  • These reviews formed part of 16/17 contract negotiations between the CCG’s and NUH for all non-tariff service commissioned using a ‘locally agreed price’.
  • The majority of reviews have resulted in a proposal that services remain at NUH with an updated specification. A number of reviews resulted in proposals that service be moved either to a community setting or the patient’s own home.
  • CCGs went out to engagement on the following services under the proposal to move these services into the community:

(please note that these are the original proposals –  they will be updated on CCG websites within the next two weeks)

  • Other services which were reviewed but are staying with Nottingham University Hospitals
    • Community Geriatricians
    • Clinician to clinician advice and guidance
    • Healthcare Associated Infection service
    • Clinical psychology
    • Outpatient Physiotherapy and Orthopaedic Rehab
    • Outpatient Speech and Language Therapy
    • Specialist Palliative Care day care
    • Community Paediatrics
    • Orthotics
    • Outpatient parenteral antimicrobial therapy (OPAT)
    • Critical Care Outreach
    • Pre-operative Assessments
    • Anti-Coagulation Remote Dosing Service
    • Outpatient Occupational Therapy
    • Home Visits for patients on home dialysis
    • Dietetics Total Parenteral Nutrition (TPN)
    • Hepatitis Service
    • Audiological Medicine
    • Dose Adjustment for Normal Eating (DAFNE) – Diabetes Education




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